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Genitourinary Imaging |
1 From the Department of Radiology, Chelsea and Westminster Hospital, London, England. From the 1998 RSNA scientific assembly. Received February 17, 1999; revision requested March 17; revision received June 3; accepted June 15. Address reprint requests to P.R.B. 39 Hanover Gardens, Oval, London NE 11 5TN, England. (e-mail: paulburn@lesbaux.demon.co.uk).
PURPOSE: To evaluate the magnetic resonance (MR) imaging appearances of uterine fibroleiomyoma before and after embolization and to determine whether there are preembolization MR imaging characteristics that are predictive of a successful outcome.
MATERIALS AND METHODS: MR imaging was performed in 18 patients (32 fibroleiomyomas) before and at 2 and 6 months after embolization of the uterine arteries. On each occasion, fibroleiomyoma signal intensity and gadolinium enhancement characteristics were assessed in comparison with those of myometrium on T1-weighted and gadolinium-enhanced images or with those of skeletal muscle on T2-weighted images. Fibroleiomyoma volume was measured by using the ellipsoid formula.
RESULTS: The mean fibroleiomyoma volume before embolization was 340 cm3 (range, 15–1,383 cm3). The mean reduction in fibroleiomyoma volume was 43% at 2 months and 59% at 6 months. Before embolization, high signal intensity on T1-weighted images was predictive of a poor response (P = .008), and high signal intensity on T2-weighted images was predictive of a good response (P = .007). The degree of gadolinium enhancement was not correlated with fibroleiomyoma volume reduction (P = .46).
CONCLUSION: MR imaging was useful for evaluation of changes in fibroleiomyoma volume after uterine arterial embolization. MR imaging characteristics of fibroleiomyomas before embolization can help predict subsequent response to treatment.
Index terms: Arteries, MR, 969.129411, 969.129412, 969.12942, 969.12943 • Arteries, therapeutic embolization, 969.1264 • Uterine neoplasms, 854.1264, 854.315 • Uterine neoplasms, MR, 854.121411, 845.121412, 854.12143
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